Medicine and Health Sciences Commons^™

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

The Diffusion Of Telehealth: System-Level Conditions For Successful Adoption, Danika Tynes

Dissertations

Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory. System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using multiple logistic regression.

Analyses included data from 84 states leveraging data from the World Health Organization, World Bank, ICT Index, …

Same-Sex Sexual Coercion Among Women: The Impact Of Minority Stress On Perpetration And Victimization Experiences Of Women Of Diverse Sexual Identities, Allison Kirschbaum

Dissertations

The purpose of the current study was to investigate women’s experiences with same-sex sexual coercion perpetration and victimization. Specifically, I sought to explore the role that the stress of living as a sexual minority plays in these experiences as well as to determine whether the psychological variables of perceived powerlessness, psychological distress, social support, and alcohol use mediate the relationship between minority stress and perpetration and victimization experiences. Data were collected online from self-identified women and individuals assigned female at birth who reported experiencing genital sexual contact with another woman (N=339). Of the cisgender women in the sample, 31.6% reported …

A Vaccine Administration Training Program To Increase Adolescent Vaccination Rates, Claire Jensen

Dissertations

Abstract

Immunizations have been proven to control life-threatening diseases. Often Registered Nurses (RNs) administer vaccines but are unsure how to discuss vaccines with vaccine hesitant patients. Missouri’s adolescent vaccination rates are below its neighboring states. This initiative’s purpose was to increase adolescent vaccine administrations at a Missouri County Health Department (MCHD).

This quality improvement initiative had an observational, cross-sectional, descriptive design. RNs employed at three MCHD clinics attended an adolescent vaccine administration training program (VAT) and completed pre-/post-tests regarding the Advisory Council on Immunization Practices recommendations. Medical record reviews from March 1-April 30, 2018 and March 1-April 30, 2019 compared …

A Behavioral Weight Loss Program For Low-Income Adults With Obesity And Hiv, Sophai Thach

Dissertations

Problem: Obesity, having a body mass index (BMI) of 30 kg/m² or greater, increases the risk for cardiovascular disease. For people living with HIV (PLWH), this increases their risk for myocardial infarctions by 50% and causes this life-threatening event to occur at a younger age compared to those who are not diagnosed with HIV.

Methods: With obesity disproportionately affecting people with low income, this study aims to evaluate the effects of a 12-week behavioral weight loss program that utilizes journaling as a self-monitoring tool, weekly educational classes, and individualized goal-setting on PLWH with obesity who live in …

The Lived Experience Of Discharged And Readmitted African Americans With Chronic Obstructive Pulmonary Disease To A Safety-Net Hospital, Kiiyonna Jones

Dissertations

Background:Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory disease that negatively affects the quality of life of those affected and has been a major contributor to the continuous rise in healthcare cost in the Unites States (Guarascio, Ray, Finch, & Self, 2013; National Heart Lung and Blood Institute, 2009; Shavelle, Paculdo, Kush, Mannino, & Straus, 2009; Scott, Smith, Sullivan, & Mahajan, 2001). In 2014, Centers for Medicare & Medicaid Services (CMS) identified COPD as an applicable condition to the Hospital Readmissions Reduction Program, which penalizes healthcare organizations having readmissions higher than the national average. COPD is the second …

G.I. Jane Fem Etran Goes Corporate: An Exploration Of Post-9/11 Female Combat Veterans Transitioning To A Civilian Career, Tumona Austin

Dissertations

Purpose: The purpose of this multiple-case study was to explore the experiences of post- 9/11 female combat veterans transitioning from military service to civilian careers, using the Schlossberg transition model factors of situation, self, social support, and strategies.

Methodology: This multiple-case study identified and interviewed post-9/11 female combat veterans transitioning from active-duty to civilian career. Respondents were purposively chosen based on specific criteria and expert panel recommendations.

Findings: Examination of case-study interview data and artifacts from the 3 post-9/11 female combat veterans indicated nine major findings:

1. The factor of situation clearly outweighed the other Schlossberg factors in impact.

2. …

A Collaborative Perspectives Approach For Understanding Effective Care Coordination In Autism Spectrum Disorder, Rachel Severs

Dissertations

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that causes significant impairment in social and communication areas. The severity of the disorder can often result in a substantial degree and amount of service access and expenditures relating to a child’s needs. This study examined the experiences of how family caregivers and service providers of children with ASD view service delivery using a basic qualitative research design. For the study, 10 participants (five family caregivers and five service providers) were enrolled and interviewed. Interview data were collected and coded to produce a qualitative analysis of the experiences of these individuals who …

Redefining Burnout: Exploring Common Conceptualizations And The Neurophysiology Of Chronic Stress To Establish An Integrated Allostatic Model, Danny A. Guzzi

Dissertations

Burnout is a widely researched stress-related phenomenon associated with numerous adverse outcomes for employees and organizations. Unfortunately, burnout is not well understood and research to this point has been flawed due to a lack of consensus on the definition, dimensionality, and context of the construct. Prevalent conceptualizations of burnout have been criticized for being arbitrarily developed without solid theoretical foundation and for failing to clearly distinguish burnout from depression or other work-related conditions such as compassion fatigue, secondary traumatization, and vicarious traumatization. The current project first examines relevant literature to identify commonalities among prevalent burnout conceptualizations. Then relevant stress research …

Adventist Healthcare: A Qualitative Study Of 19th Century Founding Governing Principles In 21st Century Adventist Hospitals, Cesiah Yareth Pimentel Melendez

Dissertations

Problem and Purpose

Founding values and principles can help organizations stay focused on fulfilling their mission. This is especially true in faith-based organizations that seek to continue their founding principles as a governing commitment to their core identity. This study identified Adventist healthcare founding principles in Ellen G. White's early health visions and explored how Adventist healthcare leaders perceived these principles as governing principles applied to current Adventist healthcare practices.

Conceptual Framework and Research Design

Two metaphors and three areas of literature review guided my approach of this qualitative study of Adventist healthcare founding principles. My first metaphor of DNA …